HomeMy WebLinkAbout03-13-14 1505610143
REV-1500 FX(02-11) IV OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania county coda rear File Number
Bureau of Individual Taxes oasuTMSxror vavawe
PO 60X.280601 INHERITANCE TAX RETURN 21 13 964
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
08 17 2013 03 03 1923
Decedent's Last Name Suffix Decedent's First Name MI
SLOAN ESTHER M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
0 1. Original Return 2. Supplemental Return 3. Remainder Return(Dale of Death
Prior to 12-13-82)
El 4. Limited Estate ❑ 4a.Fulure Interest Compromise F—] 5. Federal Estate Tax Return Required
(date of death after t 2-12-82)
6. Decedent Died Testate 7. e`t�,�o��oast a LNirg Trull 0
(Atlatlr Copy of will) At1a o ) 9. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received 10.g��Paf�� a {Da�%o r Death 11,Election to tax under Sec.9113(A)
(Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
SHARON E MYERS 717 848 4900
C7 r_>
REGISTER OEt"LLS USF�ONLY .-n7l
First Line of Address �(7 :—moo t?
135 NORTH GEORGE STREET =z CD
Second Line of Address np CD
� 'v T
City or Post Office State ZIP Code D E FILED O,
YORK PA 17401
Correspondent's e-mail address: smyers(dcgalavv.com
- Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is uue,correct and Complete.Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge.
SIG AT7E OF/P/ T
ERS NS FOR F DING RETURN Op��
Donald Fisher 77
ADDRESS
_428 Lewisberry Road, New Cumberland, PA 17070
SIGNA REP R ER THAN REPRESENTATNE Dqbo
Sharon E. Myers
ADDRESS
106 Harrisburg St.,York, PA 17401
Side 1
1505610143 1505610143 J
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Sloan, Esther M.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 22 , 495 . 13
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) u Separate Billing Requested............ 7. 148 , 127 . 41
8. Total Gross Assets (total Lines i through 7)........................................................ 8. 170 , 622 . 54
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 7 , 020 . 70
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 7 , 020 . 70
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 163 , 601 . 84
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 163 , 601 . 84
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15. 0 . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable 163 601 . 84 16. 7 , 362 . 08
at lineal rate X .045 r
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18, 0 . 00
19. TAX DUE................................................................................................................ 19. 7 , 362 . 08
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-13-964
Decedent's Complete Address:
DECEDENT'S NAME
Sloan, Esther M.
STREET ADDRESS
2100 Bent Creek Boulevard
The Bridges at Bent Creek
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 7,362.08
2. Credits/Payments _
A. Prior Payments 6,000.00
B. Discount 315.79
Total Credits(A +B) (2) 6,315.79
3. Interest - (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 1,046.29
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS _
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;........................................................................ ... x
b. retain the right to designate who shall use the property transferred or Its income;......................... ...
c. retain a reversionary Interest;or............................................................................................................... x
d. receive the promise for life of either payments,benefits or care?............................................................ x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?...........................................................................................-.....
.................. ❑ ❑x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. .0 ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent(72 P.S.§9116(a)(1.1)(1)).
For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
(72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000: -
. The lax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or,a stepparent of the child is 0 percent 172 P.S.§9116(a)(1.2)].
• The lax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in(72 P.S.§9116(a)(1)].
. The lax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent(72 P.S.§9116(a)(1.3)). A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Revd SOB E) it-1tl)
SCHEDULE E
Pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAY,RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sloan, Esther M. 21-13-964
Include the proceeds of lit lion and One dale the pweeds were received by the estate.
All property)o ntlyowned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Cash 590.00
2 Coins-sold 625.00
3 Jewelry sold 275.00
4 ACNB Checking Account#1552945 17,261.13
5 Various Refunds 3,744.00
TOTAL(Also enter on Line S. Recapitulation) 22,495.13
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11.10)
Rev-7510 EX.(09 49)
SCHEDULE G
Pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sloan, Esther M. 21-13-964
This schedule must be completed and filed If the answer to any of questions 1 through 4 on page three of the REV-15DO Is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OECD•S EXCLUSION TAXABLE
NUMBER THE DATE NAME TRAANSTRANSFEREE CH A COPY OFTTHE DEED FOR ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 American Equity Income Fund#658364- 148,127.41 100.000% 148,127.41
Beneficiaries: Daughters at 1/3 each:
Esther M. Fisher,Arbutus L. Ness and Rae Jean
Durschlag
TOTAL(Also enter on Line 7, Recapitulation) 148,127.41
(If more space is needed.additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09)
REV4611 EX.(1")
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE RESIDENT DEC o NT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Sloan, Esther M. 21-13-964
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 1,054.68
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Donald Fisher
Street Address 428 Lewisberry Road
City New Cumberland State PA Zio 17070
Year(s)Commission Paid 2014 2,500.00
2. Attorney's Fees CGA Law Firm 2,500.00
3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees 123.50
5. Accountant's Fees
6. Tax Return Preparers Fees 100.00
7. Other Administrative Costs 742.52
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 7,020.70
Copyright(c)2009 form software only The Lackner Group,Inc. Forth PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Sloan, Esther M. 21-13-964
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Neill Funeral Home 325.00
2 New Cumberland VFW Post 7415-Funeral Luncheon 729.68
H-A 1,054.68
Other Administrative Costs
3 Alert Pharmacy 5.00
4 Cumberland Law Journal -Advertise letters 75.00 .
5 Miscellaneous costs to finalize estate 500.00
6 Register of Wills-Additional Probate fees 30.00
7 The Sentinel-Advertise letters 132.52
H-B7 742.52
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA4500 Schedule H(Rev.6-98)
REV-1613 EX.(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sloan, Esther M. 21-13-964
RELATIONSHIP TO '
NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
Do Not List PERSON(S)RECEIVING PROPERTY (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.91 16 a 1.2
Rae Jean Durschlag - Daughter 1/3 residue
7184 SW 22 Place
Davie, FL 33317
Esther M. Fisher Daughter 113 residue
428 Lewisberry Road
New Cumberland, PA 17070
Arbutus L. Ness - Daughter 1/3 residue
Cozy Court, Box 4
371 Old York Road
New Cumberland, PA 17070
Total
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet as appropriate.
NON-TAXABLE DISTRIBUTIONS:
IT. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II —ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. _ Form PA-1500 Schedule J(Rev.01-10)
WILL AND TESTAMENT
I, ESTHER M. SLOAN, of York Springs, in the County of
Adams and State of Pennsylvania, being of sound mind, memory and
understanding, do make and publish this my last will and testament,
hereby revoking and making void all former wills by me at any time
heretofore made.
And first, I direct that my funeral be conducted in
manner corresponding with my estate and situation in life and that
all my just debts and funeral expenses be fully paid and satisfied
as soon as conveniently may be after my decease.
As to such estate as it hath pleased God to intrust me
with, I dispose of the same as follows, viz:
I. I hereby expressly authorize and empower my Executor to
liquidate all of my assets into cash, real, personal or mixed,
wheresoever situate, at either public or private sale, whichever
in his discretion shall be deemed to be in the best interest
of my estate; and after the payment of all debts, taxes, costs
and expenses, I hereby make the following bequests, to wit:
(a) I bequeath the remaining proceeds, equally, share
and share alike, to my children, Esther M. Fisher, Arbutus
L. Ness and Rae Jean Durschlag.
Page 1 -
Ii. I further direct, that in the event only, if any of my said
daughters should predecease me, that in such event, I make
the following provision, regarding their respective share,
to wit:
(a) If my daughter, Arbutus L. Ness, should predecease
me, having no children of her own, her respective share shall
pass and be distributed to my daughters, Esther M. Fisher and
Rae Jean Durschlag, equally, share and share alike.
(b) If my daughter, Esther M. Fisher, should predecease
me, then her share shall pass to her children, equally, share
and share alike.
(c) With regard to my daughter, Rae Jean Durschlag,
if she should predecease me, then her share shall pass to my
grandson, Michael D. Durschlag, provided he has attained at
least 18 years of age. If he has not attained 18 years of
age, I appoint Esther M: Fisher, as Trustee-Guardian of his
respective share, without the necessity of posting bond and
without the necessity of any prior court approval, to invest
the moneys in a Federal Insured Institution and to hold the
same in trust for him until he would attain age 18, at which
time he would be entitled to receive the balance of the trust
shall terminate.
III. I further expressly direct, that any and all Inheritance Tax
Page 2 -
due from my estate, shall be paid from my residuary estate
before any distribution shall be made, or any distributive
shares are first determined. Further, any sales conducted
by my Executor, shall not require court approval.
And I hereby nominate, constitute and appoint Donald
Fisher, my Executor, and if he should predecease me or is' unable
serve•, I hereby nominate and appoint Donald Ray Fisher, Executor,
of this last Will and Testament, without the necessity of posting
bond.
IN WITNESS WHEREOF, I, ESTHER M. SLOAN, the Testatrix,
have to this, my Will, written on three (3 ) sheets of paper, set
my hand and seal this
_Z day of June, A.D. One Thousand Nine
Hundred and Ninety-three (1993 ) .
(SEAL)
Esther M. Sloan'
Signed, sealed, published and declared by the above
named Testatrix, as and for her last Will and Testament, in the
presence of us, who have hereunto subscribed our names at her
request as witnesses thereto, in the presence of the said Testatrix
and of each other.
—Page 3 -
L.� SEP 16 2013
ACNB
BANK
September 13,2013
CGA Law Firm
Attn: Sharon E Myers
135 N George St
York PA 17401
RE: Estate of Esther M Sloan
Dear Ms. Myers:
The following information is being provided as per your request:
Acct.Type Account No. Balance at Accrued Ownership Date
D.O.D. interest to Opened/Joint
D.O.D.
Esteem 1552945 $17,261.13 $0.00 Individual 12/1/88
Checking
Account
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company
at 1-800-368-5948. If you need any additional information, please contact me at(717)339-5122.
Sincerely,
Barbara J Wamer
ACNB Bank
Deposit Services Representative 11
acnb.com•acnbbusiness.com• P.O.Box 3129,Gettysburg,PA 17325 •Phone 717.334.3161 •Toll Free 1.888.334.ACNB(2262)
V
AMERICAN
ewm mvesuwr uce
NSUHANCE COMPANY
October 01, 2013
CGA LAW FIRM
CGA PROFESSIONAL CENTER
C/O SHARON E MYERS
135 N GEORGE ST
YORK, PA 17401
Re: Esther M.Sloan•Deccased
Annuity Contract No. 658364
Dear Sharon E Myers:
The account values as of the date of death on August 17`h, 2013 on the above listed non-qualified
annuity contract are as follows:
Date.of Death•Value: $148,127.41
Taxable Amount: $0.00
Basis: $148,127.41
The named Beneficiaries are as follows:Arbutus Ness, Ester Marie Fisher, and Rae Jean Dursenlag.
Interest will be credited from date of death forward.
If you have any questions regarding your beneficiary claim, feel free to contact our office at
1-877-542-8847.
Sincerely,
&&/J
Clinton Eshelman
Annuity Claims Service Specialist
cc: Leslie"B Roberts.-, .54192
DVALU J 1f�Cf�
F C/ LI�GC/ �/�GG•i/
�I I People Service Future
P.O. Box 71216 • Des Moines, IA 50325 • 1-888-221-1234 • 515-221-0002 • 515-221-9947(Fax) •www.american-equity.com
D & S COINS
224 FOURTH STREET
NEW CUMBERLAND,PA. 17070
(717)774-4182
Customer's
Order No. DATE—!?411Z
OUGHT/ OLD TO
ADDRESS
PAYMENT METHOD- CASH CHECK
QUAN. DESCRIPTION PRICE AMOUNT
ALL Claims and Returned Goods MUST be accompanied By This Bill
SIGNATURE
r
,
f D & SCOINS ,
224 FOURTH STREET
NEW CUMBERLAND,PA. 17070
(717)774-41$2
Customer's
Order No. DATE, .
1
BOUGHT/SOLD TO C
ADDRESS
k
PAYMENT METHOD - CASH CHECK
QUAN. DESCRIPTION PRICE AMOUNT !
G�eJy
a
iI
4
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i
ALL Claims and Returned Goods MUST be accompanied By This Bill
SIGNATURE
I, Order-11 1782651
TO
il DATE
o �+er 9
ADDRESS �� - DATE IRED
Le1., � 5
CffY,STATE, /1 TERMS
Q `u:wl b2r'anc�
SHIP TO NOW SHIPPED
ADDRESS
REO.NO.OR DEPT.
CITY,STATE,ZIP FOR I
QUANTITY DESCRIPTION PRICE UNIT
1
2
b
I
6
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16
it
12
13 �
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15 I
IMPORTANT
Purchase Order Number must appear on all Please send copies of your INVOICE
ImrolCea-packaging,etc, with ORIGINAL B01 OF LADING.
Please notify us Immedlately N you are unable
ID complete the order by date speolRed.
„� 6 e
ORIGINAL -„